Gelişimsel Kalça Displazisi Hastalarında Tanı ve Tedavide Gecikme Nedenlerinin Araştırılması

Abstract

Abstract Objective: Developmental dysplasia of the hip (DDH) is an important public health problem. A delayed diagnosis and treatment may lead to increased treatment costs and disability. The purpose of our study is to present the causes of delay in the diagnosis and treatment of DDH patients who applied to our clinic. Material-Method: Forty-four patients who were 3-12 months old, were admitted to our clinic between January 2017 and January 2020 and diagnosed with DDH were included in the study. The age, gender, birth order, familial history, history of swaddling, reason for and the time to delayed diagnosis, previous treatment methods and sociodemographic characteristics of the patients were analyzed retrospectively. Results: Of the 44 patients included in the study, four (9.1%) were boys and 40 (90.9%) were girls. The average age was 5.44 months (mean: 3.5-12). Nineteen patients (43.2%) were the first children in their families. Eleven patients (25%) had a positive family history, and 22 (50%) had a history of swaddling. Of the patients with DDH in the study; the reason for late presentation was a hip USG report with normal results in six patients (13.6%), neglect due to social reasons in eight patients (18.2%), provision of insufficient information in two patients (4.5%), and treatment with multiple diapers in 28 patients (63.6%). While there was no statistically significant difference between the delay time and cause of delay (p=0.538), a significant difference was found between the delay time and the treatment method (p=0.006). Conclusion: The most important factor for delayed diagnosis and treatment of DDH was the wrongful USG evaluation of the hip and the failure to follow the appropriate treatment protocol based on the hip USG results. The continued use of multiple diapers in DDH patients older than 3 months has an adverse effect on the treatment approach.